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I tested the html on my form and received a confirmation email as well as the submitted information. If I go to another computer and try it, I get the wrong url message. My page is located at chapelhillrmh.net/referral.html. I have copied and pasted html repeatedly. Thanks for your help!

It appears to be working on my computer (under both IE and Firefox). Is it possible that you could have some spyware on your machine that is messing with the referring URL data that is submitted from web browsers?